Exit Registration Form 

Societies Membership Registration Form

 

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1. Surname:

Surname:

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2. First name:

First name:

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3. Which Society are you joining?

Which Society are you joining?   Aerospace African-Caribbean Society Amnesty Architecture Band Built Environment Students Capoeira Cath Soc Cheerleaders Chess Christians in Science Christian Union Computer Contemporary Dance CY Sheffield Drama DJ Elysium English Environmental Fashion Networking FIFA Appreciation Film Games Development Geography Greek and Cypriot Harmonies	Hobby Soc Health Improvisational Comedy Indian International Students International Students for Social Equality Islamic Japanese Visual Arts Mario Kart NUT Oriental Politics (Debate) Psychology Racing Rock Salsa SAMEEM Skate Socialist Workers Student Society Sociology South Park Sri Lankan Street and Breakdance Stop the Traffik Tamil Tea Drinking Volleyball Supporters
Other Society (please specify)

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4. SHU ID:

SHU ID:   Please enter the number on your SHU Card, or enter 0 if you are not a current SHU student

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5. Mobile number: (Please enter as 07890 123456)

Mobile number: (Please enter as 07890 123456)

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6. SHU email address: (Please double check your spelling)

SHU email address: (Please double check your spelling)

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7. Term-time address:

Term-time address:

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8. Personal email address: (Please double check your spelling)

Personal email address: (Please double check your spelling)

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9. Home address:

Home address:

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10. Next of kin details:

Next of kin details:   Full Name
Relationship (e.g. mother)
Telephone Number (enter as 01234 987654)

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11. PLEASE READ THE FOLLOWING TEXT CAREFULLY - It is the responsibility of the individual to inform the Society's Committee/Trip/Event organiser, of any relevant medical conditions the Union should be aware of which may affect your safe participation in the society activities.

I agree:

• to act in accordance with the above statement and within the code of practices that are relevant to the activities in which I will participate

• that the information in this form is correct to the best of my knowledge

PLEASE READ THE FOLLOWING TEXT CAREFULLY - It is the responsibility of the individual to inform the Society's Committee/Trip/Event organiser, of any relevant medical conditions the Union should be aware of which may affect your safe participation in the society activities. I agree: • to act in accordance with the above statement and within the code of practices that are relevant to the activities in which I will participate • that the information in this form is correct to the best of my knowledge   Yes - I agree

No - I do not agree

Known medical conditions/allergies

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12. PLEASE READ THE FOLLOWING TEXT CAREFULLY - Hallam Union are committed to maintaining your information to meet the requirements of the Data Protection Act (1998). Appropriate technical and organisational measures shall be taken against unauthorised or unlawful processing of personal data and against accidental loss, disclosure, destruction of, or damage to, personal data that you have provided. The information provided above must be accurate and up to date, and by completing this form you agree that the information provided may be used for the purpose of sending relevant information and promotions directly to you (this includes the Societies' newsletter). If you DO NOT wish to receive such information please tick the NO box below.

PLEASE READ THE FOLLOWING TEXT CAREFULLY - Hallam Union are committed to maintaining your information to meet the requirements of the Data Protection Act (1998). Appropriate technical and organisational measures shall be taken against unauthorised or unlawful processing of personal data and against accidental loss, disclosure, destruction of, or damage to, personal data that you have provided. The information provided above must be accurate and up to date, and by completing this form you agree that the information provided may be used for the purpose of sending relevant information and promotions directly to you (this includes the Societies' newsletter). If you DO NOT wish to receive such information please tick the NO box below.   Yes (recommended)

No